多种不同梅毒检验方法检测梅毒螺旋体的结果准确率比较

目的对比三种不同梅毒检验方法检测梅毒螺旋体的结果准确率。方法选取该院确诊各期梅毒的39例患者,同期就诊的30例乙型肝炎患者与体检的30例健康受试者。采用梅毒酶联免疫吸附法、梅毒螺旋体明胶颗粒凝集试验及梅毒甲胺红不加热血清反应素试验进行检测并比较其结果。结果梅毒甲胺红不加热血清反应素试验的假阳性率为2.02%,另外两种检验方法的假阳性率均为0%。梅毒甲胺红不加热血清反应素试验的总阳性率为87.18%,假阴性率为12.82%;梅毒酶联免疫吸附测定法的总阳性率为97.43%,假阴性率为2.56%;梅毒螺旋体明胶颗粒凝集试验的总阳性率为100.00%,假阴性率为0%。梅毒螺旋体明胶颗粒凝集试验的敏感度明显高于梅毒甲胺红不加热血清反应素试验以及梅毒酶联免疫吸附测定法的敏感度(P0.05)。梅毒酶联免疫吸附测定法的敏感度明显高于梅毒甲胺红不加热血清反应素试验的敏感度(P0.05)。结论根据临床诊断和治疗的不同需要,采用适宜的梅毒检测方法,以满足临床需求的同时,尽量减少患者的经济压力,促进医患关系的和谐发展。     

Determinants of reproductive tract infections among asymptomatic women in Harare, Zimbabwe

OBJECTIVES: To determine the prevalence of and risk factors for reproductive tract infections (RTI) among asymptomatic women attending primary health care clinics in Harare, Zimbabwe. DESIGN: A cross sectional study. MAIN OUTCOME MEASURES: Prevalent RTI, HIV and socio-demographic data. SETTING: Two primary health care clinics in Harare. SUBJECTS: 393 consecutive, consenting women aged 15 to 49 years, presenting at the clinics for antenatal care, family planning, or bringing their children to attend preventive care clinics. RESULTS: More than half of the women had at least one ongoing RTI. Voluntary reporting of symptoms was almost non-existent. Prevalence of HIV was 29.3% and that of classical STIs was 15.4% Trichomoniasis vaginalis, 3.9% syphilis, 3.9% Chlamydia trachomatis and 1.8% Neisseria gonorrhoea. Bacteria vaginosis was diagnosed in 30.3% of the women and candidiasis in 25.4%. Presence of any RTI was significantly associated with lower level of education, sexual debut < 20 years, a non-monogamous partner, and use of a condom during the last sexual encounter. Independent factors associated with cervical infections were young age (< 20 years), being unmarried, current dysuria, warts, clinical signs of purulent or yellowish discharge, lower abdominal pain and cervical friability. Vaginitis was associated with sexual debut or marriage < 20 years, a partner who was a frequent traveller, history of STI, and presence of abnormal vaginal discharge. CONCLUSION: In view of the high prevalence of RTI and HIV and the low reporting of symptoms by infected women, it is recommended that strategies that improve women's awareness of urogenital symptoms be adopted, along with pro-active inquiry of genital symptoms by the health care workers, and treatment of RTIs, in order to reduce the unnecessary burden of RTIs.     

韶关地区无偿献血者梅毒感染情况分析

目的分析2008年1月至2012年12月期间韶关地区无偿献血者梅毒感染情况,为今后采取预防保证血液安全措施提供依据。方法采用酶联免疫吸附法（ELISA）试剂盒检测献血者梅毒螺旋体（treponema pallidum,TP）抗体,分析梅毒感染的流行病学特征。结果共检测129504名无偿献血者TP抗体,总阳性率0．71％,呈逐年上升趋势。无偿献血者男女性别间的比较差异无统计学意义（P〉0．05）;而不同年龄组、不同文化程度、户口类型、婚姻状态的无偿献血者感染率比较差异有统计学意义（P〈0．01）。结论韶关地区无偿献血人群梅毒感染率呈上升趋势。     

妊娠梅毒患者母婴传播的检测及干预治疗

目的 探讨妊娠梅毒检出率及干预治疗对阻断母婴传播的效果.方法 对孕妇及新生儿进行快速血浆反应素环状卡片试验(RPR)及梅毒密螺旋体血凝试验(TPPA)确诊检查,对妊娠梅毒患者及其分娩的新生儿进行干预治疗并随访观察.结果 在5194例孕妇中,RPR与TPPA均阳性117例,妊娠梅毒检出率为2.25％;在5 078例新生儿中,新生儿梅毒检出率为0.91％;孕妇治疗干预与新生儿脐带血梅毒快速血浆反应素(RPR)滴度的关系密切;新生儿脐带血RPR滴度随孕母RPR滴度升高而升高.结论 早期诊断妊娠梅毒是阻断、改善妊娠梅毒结局和降低先天梅毒发生率的关键,应加强孕前及孕期的梅毒检测及综合干预治疗,有效阻断母婴垂直传播.     

骨科急诊手术4 381例术前感染性指标检测结果分析

目的 探讨骨科急诊手术患者术前感染性指标的患病率,分析骨科急诊手术患者术前感染性指标的分布与流行状况.方法 采用酶联免疫试验法检测4 381例骨科急诊手术患者术前的甲型肝炎病毒（简称甲肝）抗体、丙型肝炎病毒（简称丙肝）抗体、人类免疫缺陷病毒（1/2）型抗体（抗HIV1/2）及梅毒螺旋体抗体（TPAb）.结果 男性患者丙肝和梅毒抗体的阳性率分别为0.228％、0.821％,女性患者丙肝和梅毒抗体的阳性率分别为0.366％、0.686％,不同性别间差异均有统计学意义（Х^2=3.543、3.631,均P＜0.05）.青年组、中年组、老年组的甲肝抗体阳性率分别是0.000％、0.329％和0.101％;丙肝抗体阳性率分别为0.107％、0.591％和0.203％;梅毒抗体阳性率分别为0.160％、0.854％和1.722％;HIV抗体阳性率分别为0.000％、0.131％和0.000％.老年组与青年组比较,丙肝抗体和梅毒抗体阳性率差异均有统计学意义（Х^2=3.654、5.743,均P＜0.05）;中年组与青年组比较,丙肝抗体、梅毒抗体、HIV（1/2）型抗体、甲肝抗体阳性率差异均有统计学意义（Х^2=3.543、3.854、5.432、3.432,均P＜0.05）;老年组与中年组比较,丙肝抗体、梅毒抗体、HIV（1/2）型抗体、甲肝抗体阳性率差异均有统计学意义（Х^2=3.546、3.6431、3.564、3.433,均P＜0.05）.结论 骨科急诊手术患者术前均有可能被甲肝、丙肝、人类免疫缺陷病毒、梅毒感染.     

河北省滦南县523例性病门诊就诊者性病艾滋病流行病学分析

目的:了解河北省滦南县性病门诊就诊者性病艾滋病流行状况及危险因素,为性病门诊就诊者人群的艾滋病防治提供科学依据。方法:采用问卷调查的方式,对2009年1月-12月在滦南县性病门诊就诊者进行行为状况调查;采用ELISA方法进行HIV、梅毒血清学检测。结果:在性病门诊就诊者中性病艾滋病总感染率为17.97%(94/523),其中H IV感染率为0.19%(1/523);梅毒感染率为8.99%(47/523),各种性病艾滋病合并感染占2.10%(11例)。最近3个月内,46.85%(245例)有非婚性伴,但与非婚性伴发生性行为时,仅有28.16%(69例)每次都使用安全套。结论:在性病门诊就诊者中性病感染率较高,非婚性行为和每次使用安全套的比例低是危险因素。建议加强性病艾滋病防治的宣传教育工作,推广应用安全套工程,推动性病艾滋病自愿咨询检测,对性病及艾滋病患者进行诊疗,提高性病艾滋病防治工作的效果。     

酶联免疫吸附试验诊断梅毒螺旋体感染的临床价值

目的 探究梅毒螺旋体(TP)感染中应用酶联免疫吸附试验(ELISA)诊断的临床价值.方法 150例疑似梅毒螺旋体感染患者,分别采用酶联免疫吸附试验及快速血浆反应素环状卡片试验(RPR)进行诊断,以梅毒螺旋体明胶凝集试验(TPPA)检测结果为金标准,分析梅毒螺旋体感染阳性和阴性患者的检测结果,并对比酶联免疫吸附试验及快速...     

2012年广西凭祥市艾滋病哨点各类人群监测结果分析

目的了解广西凭祥市各类人群中艾滋病流行状况及相关行为特征,为开展有效的干预工作提供依据。方法按照《全国艾滋病哨点监测实施方案操作手册》,在2012年4～6月,对符合条件的吸毒者、性病门诊男性就诊者、长途卡车司机、孕产妇等4个人群分别连续抽样,进行面对面的问卷调查,并采集静脉血样进行人类免疫缺陷病毒(HIV)、梅毒和丙型肝炎病毒(HCV)等抗体检测。结果 2012年共监测4类人群1 600人。吸毒者HIV、梅毒和HCV的抗体阳性率最高,分别为3.25%、6.00%和36.50%,差异均有统计学意义(P<0.01)。调查对象答对8条(全对)艾滋病知识的以性病门诊男性就诊者最高,为82.25%,长途卡车司机最低,仅为52.00%,差异有统计学意义(χ2=116.237,P<0.01)。吸毒者最近一年发生过商业性行为的比例为39.5%,发生商业性行为时每次坚持使用安全套的比例只有37.97%,但是与配偶或固定性伴发生性行为时,从未使用安全套的比例为26.92%;性病门诊男性就诊者,最近3个月发生过商业性行为的比例为17.75%;长途卡车司机最近1年发生过商业性行为的比例为2.25%;0.25%的孕产妇有吸毒史,0.5%的孕产妇其丈夫有吸毒史;0.75%的孕产妇有婚外性行为。从2009—2012年凭祥市各类人群的HIV抗体阳性率变化趋势来看,吸毒者HIV抗体阳性率比较高,但有逐年下降的趋势。结论凭祥市艾滋病疫情呈低流行态势,但影响艾滋病流行的危险因素仍广泛存在,针对各类人群的特点,必须进行有效的行为干预,以遏制艾滋病的进一步蔓延。     

Validation of a Romanian scale to detect antenatal depression

The aim of this study was to develop and validate a linguistically and culturally appropriate version of the Edinburgh Postnatal Depression Scale (EPDS) for use with women attending antenatal care in Romania. We translated and tested a Romanian version of the EPDS (EPDS-R) in four hospitals in three Romanian cities: Cluj-Napoca, Satu Mare, and Sighetu-Marmatiei. The study population included third-trimester women attending antenatal clinics (n=418); 364 subjects were included in the analytic sample. We used the Center for Epidemiologic Studies Depression Scale (CES-D) as a “gold standard”. We assessed reliability, validity, and conducted sensitivity analysis to establish an EPDS-R cutpoint. We found that reliability was robust (α=0.89) and there was a significant linear relationship between EPDS-R and CES-D scores (r=0.77; p<0.001). We established an EPDS-R cutpoint of >12 to balance sensitivity and specificity. Principal component analysis revealed a two-factor solution. We detected antenatal depressive symptoms prevalence rates of 32% (CES-D) and 38% (EPDS-R). This is the first study to report exclusively on antenatal depression and the use of the EPDS in Central and Eastern Europe. The EPDS-R is easy to administer, reliable, and valid for screening depression among antenatal women in Romania.     

注射毒品者梅毒感染状况及其危险因素研究

目的评估注射毒品者梅毒感染水平及其影响因素,为在该人群中预防和控制性病提供基础资料。方法对2001年5月-2002年6月在北京市社区和强制戒毒所招募的232例注射毒品者进行匿名问卷调查,调查内容有人口学特征、毒品使用行为、性行为、艾滋病知识和相关行为。调查结束后采取静脉血5ml,试验室检测梅毒螺旋体感染情况。结果本次调查的注射毒品者中梅毒感染率为5.17%,女性是注射毒品者感染梅毒的影响因素。结论注射毒品人群中梅毒的感染率远高于普通人,且女性是梅毒感染的危险因素,建议对此人群的干预措施应结合高危性行为,尤其对女性。     

深圳市宝安区美沙酮门诊海洛因依赖人群HIV、HCV和梅毒感染状况分析

目的：了解深圳市宝安区美沙酮门诊海洛因依赖人群HIV、HCV和梅毒感染状况,为相应的疾病控制干预提供科学依据。方法：对参加维持治疗的249名海洛因依赖者进行HIV、HCV和梅毒血清学检测。结果：HIV抗体阳性率1．2％（3／249）;HCV抗体阳性率62．2％（155／249）,其中静脉注射吸毒者HCV阳性率72．82％（142／195）明显高于非静脉吸毒者24．07％（13／54）（P〈0．001）;梅毒抗体阳性率2．0％（5／249）;3名HIV及5名梅毒阳性患者均合并感染HCV。结论：深圳市宝安区美沙酮门诊海洛因依赖人群中HCV感染率较高,尤其是静脉注射吸毒者。     

Seroprevalence of HIV infection amongst antenatal women in greater Harare, Zimbabwe.

Prevalence of HIV infection appears to be rising in many African countries. HIV infection in the pregnant woman poses a dilemma for the mother as well as for her unborn child. There are no data on HIV prevalence in Zimbabwe. This prospective study designed to determine HIV prevalence, enrolled pregnant women booking for antenatal care at Harare hospital and two of its peripheral municipal clinic. Two Elisa and a confirmatory Western Blot test on 1008 blood samples provided an HIV sero-prevalence rate in the studied population of 18 pc. High groups included unskilled labourers who were unbooked, single, divorced or cohabiting and below 30 years of age. Regarding education and income, women with over 11 years of education or earning over $600 per month constituted a lower risk category. Implications of this high prevalence rate are discussed and the urgency to examine feto maternal transmission and the effect of pregnancy on HIV status is expressed. Further more, intensification of preventive information and education programmes is recommended.     

Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England

BackgroundThere is little information on the prevalence of recreational drug use among UK heterosexual men and women, in particular on use of drugs associated with ‘chemsex’ within gay communities. The aim of this study was to examine among HIV-negative and HIV-positive heterosexual men and women in England: (i) the prevalence of recreational drug use (including use of drugs associated with chemsex), (ii) socio-economic/lifestyle correlates of drug use, and (iii) the association of drug use with sexual behavior measures and mental health symptoms.MethodsData are from the AURAH study of HIV-negative individuals attending sexual health clinics across England (2013–2014) and the ASTRA study of HIV-positive individuals attending HIV outpatient clinics in England (2011–2012). Prevalence of recreational drug use (past three months) and associations are presented separately among the four sample groups: HIV-negative (N = 470) and HIV-positive (N = 373) heterosexual men and HIV-negative (N = 676) and HIV-positive (N = 637) women.ResultsThe age standardized prevalence of any drug use was 22.9%, 17.1%, 15.3%, and 7.1% in the four sample groups respectively. In all groups, cannabis was the drug most commonly used (range from 4.7% to 17.9%) followed by cocaine (1.6% to 8.5%). The prevalence of use of drugs associated with chemsex was very low among HIV-negative participants (1.0% heterosexual men, 0.2% women) and zero among HIV-positive men and women. In age-adjusted analysis, factors linked to drug use overall and/or to cannabis and cocaine use specifically in the four sample groups included Black/mixed Caribbean and white (vs. Black/mixed African) ethnicity, lower level of education , cigarette smoking, and higher risk alcohol consumption. Associations of recreational drug use with measures of condomless sex, depression, and anxiety were observed in the four groups, but were particularly strong/apparent among women.ConclusionProviders need to be aware of cannabis and cocaine use and its potential link with sexual risk behavior and symptoms of depression and anxiety among heterosexual men and women attending sexual health and HIV clinics.     

广西河池市美沙酮门诊海洛因依赖人群HIV、HCV、TB、梅毒感染情况调查

目的獉獉:了解河池市美沙酮门诊海洛因依赖人群的特征,HIV、HCV、TB和梅毒感染情况及其危险因素。方法獉獉:对参加美沙酮维持治疗的388名海洛因依赖者进行治疗前的问卷调查,HIV、HCV、TB、梅毒血清学检测及胸部X线摄片检查。结果獉獉:87.11%的海洛因依赖者采用静脉注射方式吸毒,46.15%的静脉吸毒者共用注射器。HIV抗体阳性率7.99%(31/388),其中静脉注射吸毒HIV抗体阳性率8.88%(30/338)。HCV抗体阳性率72.16%(280/388),其中静脉注射吸毒HCV抗体阳性率74.85%(253/338)。TB抗体阳性率0.26%(1/388),梅毒抗体阳性率13.66%(53/388)。结论獉獉:河池市美沙酮门诊海洛因依赖人群,尤其是静脉吸毒者中HCV和梅毒感染较高。在海洛因依赖人群中推广针具交换、安全套免费发放和相关知识的健康教育、行为干预尤为重要。     

Situation analysis of obstetric care services in a rural district in Zimbabwe

OBJECTIVE: To conduct a situation analysis of obstetric services in a rural district of Zimbabwe. DESIGN: Observational study. SETTING: 13 primary health care centres in Murewa district in Zimbabwe. MAIN OUTCOME MEASURES: Number of maternity beds, antenatal attendance, deliveries per month, availability of antenatal, intrapartum and neonatal care equipment, intrapartum monitoring and neonatal resuscitation skills. RESULTS: 13 of 15 primary health care clinics providing obstetric care in Murewa district were surveyed in 1995. Median number of maternity beds were nine (Q1 = 0, Q3 = 11) per clinic, median number of first ANC attenders per month was 15 (Q1 = 3, Q3 = 18), median number of deliveries per clinic per month were eight (Q1 = 0, Q3 = 16). While all clinics had laboratory facilities, 6/13 could estimate haemoglobin, 5/13 syphilis serology, none of the clinics sent blood to district hospitals for blood grouping and there were no microscopes at clinics for malaria parasite determination. Only 6/13 clinics used partographs for monitoring labour, 10/13 had suction machines for neonatal resuscitation while only 3/13 had ambu bags, 3/13 had oxygen and 2/13 had heaters. Correct methods for neonatal resuscitation were used in 3/13 clinics. Clean water supply, reliable power supply and the referral system were not optimal. CONCLUSION: Basic equipment for antenatal, intrapartum and neonatal care was inadequate. Essential laboratory facilities for obstetric care were lacking. Skills for intrapartum monitoring and neonatal resuscitation were inadequate. The referral system was poor. There is need for more strategic planning at primary health care level in this district which is known to have high perinatal and neonatal death rates. More emphasis should be placed on strengthening basic laboratory back up service for obstetric care, strengthening infrastructural and referral systems as well as training in areas of lost or no skills.     

Implementation of the prevention of mother-to-child transmission of HIV programme in Zimbabwe: achievements and challenges

Recent scientific developments have led to feasible and effective interventions to reduce the risk of mother to child transmission of HIV. Even in resource poor countries, PMTCT programmes are being articulated as a priority in the national strategic frameworks. Thus PMTCT programmes are moving from being pilot projects to national programmes comprehensively integrated into other reproductive health programmes or HIV and AIDS prevention, care and support programmes. In Zimbabwe the prevention of mother-to-child transmission (PMTCT) of HIV infection has become an important national task. The 2001 national survey of HIV prevalence among women attending antenatal care revealed that 29.5% of the women were HIV positive. While an effective PMTCT programme using nevirapine can reduce the rate of this transmission by 50%, the Zimbabwe PMTCT National Expansion Programme has had its share of achievements and challenges since its launch in 2002.     

Yaws in Polynesia's Wallis and Futuna Islands: a seroprevalence survey

We carried out a serological and clinical survey to determine the prevalence and clinical presentation of yaws on two twin islands in Polynesia: Wallis and Futuna. A total of 264 serum samples were tested for specific Treponema pallidum haemagglutinations assay and non-specific rapid plasma reagin: 52 were positive for one or both tests; only one young adult had skin lesion consistent with yaws; and there were no observed cases of secondary or tertiary yaws. Our results contrast with findings in neighbouring islands, such as Vanuatu, where yaws has been reported to resurge. This difference might be explained by better availability and accessibility of healthcare on Wallis and Futuna, thus allowing widespread use of antibiotics for other bacterial diseases.     

Nontobacco Substance Use,Sexual Abuse,HIV, and Sexually Transmitted Infection Among Street Children in Kolkata,India

A community-based cross-sectional study among 554 Kolkata city street children assessed nontobacco substance use and sexual abuses along with human immunodeficiency virus (HIV)/ sexually transmitted infections (STIs) during 2007, using conventional cluster sampling technique for “hard-to-reach population” with a field-tested questionnaire and the collection of a blood sample for HIV and syphilis serology testing as a composite indicator of STIs. The reported prevalence of nontobacco substance use was 30%; 9% reported having been sexually abused. Some factors (age, lack of contact with family, orphan children, night stay at public place, etc.) were documented to be associated with substance use and sexual abuses. Seroprevalence of HIV was found to be 1% and that of STIs was 4%. This 1% HIV seroprevalence in street children is a matter of concern. Community-based intervention is necessary for them. The study's limitations are noted.     

Knowledge and perceptions of antenatal women towards prevention of mother to child transmission of HIV/AIDS in Blantyre, Malawi

OBJECTIVES: To determine antenatal attendees' knowledge and perceptions towards selected aspects of prevention of mother to child transmission of HIV. SETTING: Five rural and six urban public health centers in Blantyre District, Malawi. SUBJECTS: 126 consecutive pregnant women attending antenatal clinics. DESIGN: Cross sectional qualitative study utilizing focus group discussions (FGDs). Analysis was based on content analysis. RESULTS: Knowledge about HIV/AIDS especially regarding causative agents of AIDS, transmission and prevention was generally high in all FGDs. One individual though, suggested that HIV was transmitted by mosquito bites and another that HIV was transmitted by being exposed to persistent coughing. The majority of 126 women identified HIV testing of pregnant women as of potential benefit and necessary for the prevention and control of HIV/AIDS. In most cases, the benefit mentioned for HIV testing was that it was good to know about one's HIV status rather than being ignorant. Other suggested benefits of HIV testing of pregnant women were: future family planning, as an incentive to reduce the number of sexual partners and to know the cause of the problem in case a child is failing to thrive rather than blame witchcraft. Male spouses were identified as both potential supporters and limiting agents towards pregnant women's acceptability of HIV testing. CONCLUSION: HIV testing among pregnant women to ensure prevention of mother to child transmission of HIV is a complex issue. Women consider various factors before making decisions. Programme planners and implementing agencies need to be aware of these issues and work together with women and other stakeholders in order to overcome such limitations.